| NPI | 1215370622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 296772) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: IL 070019578) |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2019-07-12 |